Pickhardt, Mark G
Pickhardt, Mark G is an individual health care provider with primary practice located at 3302 N Northhills Blvd , Fayetteville AR 72703-4008. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Gynecology is his primary health care specialty. Pickhardt, Mark G can be contacted via phone (479) 582-3366.Contact Information
Primary practice address
3302 N Northhills Blvd
Fayetteville AR 72703-4008
Phone: (479) 582-3366
Fax: (479) 571-6572
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | C7319 | Arkansas |
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | C-7319 | Arkansas |
Profile Details
| NPI number | 1144275413 |
|---|---|
| LBN Legal business name | Pickhardt, Mark G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2006 |
| Last updated | Jul 21st, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144275413 | NPPES |
| Arkansas | MEDICAID | 119159001 | |
| Arkansas | Other | 54558 |
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